Abstract

When knowledgeable healthcare IT professionals are asked about medical imaging workflow, it is highly probable that they will speak to the use of PACS. This is understandable given the widely held notion of PACS as a critical component within this complex medical imaging workflow. From scheduling, to acquisition, to technologist review, to specialist interpretation, and the image enablement of the referring physician at the point of care, PACS plays a crucial role throughout this workflow. Over the past 15 years or so, PACS workflow has continued to be enhanced and standardized, producing improved IT interoperability which in turn has yielded improved clinical care at a lower cost.

Notwithstanding the importance of PACS in the medical imaging workflow, the importance of image data ownership, sharing and access across the enterprise is growing at a rapid pace. As images move within (and outside of) the healthcare enterprise, attributes within the image data often require normalization to enable proper viewing. Patient identifications, study descriptions, modality types, organ codes, and other DICOM attributes may need to be normalized so that the study is correctly presented to physicians and clinicians. More advanced challenges exist where images require compression, transfer syntax conversion or proprietary PACS presentation state and annotations transformations to enable viewing in another PACS. The question is, how can any healthcare system or RHIO or national health system tackle these challenges across numerous disparate PACS and modalities? How can they own and control their imaging data so that they can improve sharing and access?

This white paper identifies solutions to these challenges through outlining the Clinical Imaging Continuum. Simply stated, the Clinical Imaging Continuum is a lifecycle view of image data from its creation at a modality, to its review by specialist physicians, to its storage in the long term archive, to its inclusion in the EMR, to its recall from the archive for use as a relevant prior or for clinical research. The Clinical Imaging Continuum details this image data lifecycle and presents solutions that result in image data ownership, sharing, and access across an enterprise, RHIO or national health system.

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